I'm disappearing completely

On David Harewood’s excellent My psychosis and me on BBC2 last week, I heard a moving statistic: people in psychiatric wards get fewer “Get Well Soon” cards that people in, say, cancer or intensive care wards.

Why?  Perhaps because we lack the words to talk about psychosis or schizophrenia or madness or genius, or whatever we choose to call it.

We have moved forward in recent years in opening up about so many of the experiences that constitute human life – the extraordinary, everyday, dizzying, stuck lives that people lead.  We describe this wide range of experiences as “mental health,” and we use words like “depression” and “anxiety” and “stress” to describe them – words which don’t do justice to those expanses of life, but which may help contain the chaos or numb the sensation.


But we haven’t opened our ears so much to the experiences of people who live with psychosis.  David Harewood’s account pushed us on a little further, and in recounting that bleak statistic that black people are far likelier than their white counterparts to be sectioned rather than accessing treatment voluntarily, highlighted the sharp divides which shape mental illness.

We watched as Harewood stepped back and (re-)discovered the breakdown he experienced 30 years ago – the exhilaration of his mania, the determination with which he pursued the instructions of the voices he heard, the violence he encountered at A&E when he and his concerned flatmates sought help.

It is so valuable to hear someone talk with clarity and feeling about their encounters with psychosis.  That statistic about “Get Well Soon” cards reminds me of the misplaced idea that talking therapies don’t work for psychosis, that therapy is a waste of time.  In my experience, nothing is further from the truth.  There are great differences between how two persons with and without psychosis experience the world, but there are great similarities too – a wish to connect, to find out who I am, not to be cured, but to discover new things, to re-discover old things.

A memory from Harewood illustrates how this might be so difficult for the person with psychosis.  Recalling an audition he attended as a young actor, he is reminded that he turned up three hours late, and said to the casting director: “I’m fine, I’m well, really really well, but it’s difficult when you’re an alien, and I’m disappearing completely”.

It is difficult when you’re an alien – especially if you have nobody to bear witness to your alienation.  To be thought, but not be able to think…  To be the stage on which an incredible drama unfolds, but not be able to act on that stage…  To feel lived in, but not to live…  To feel one’s sense of self fade into the background…  To disappear completely…

Most of us have had a glimmer of this isolation, this unreal sensation.  Some of us confront it head-on, some of us bargain with it, and there may be richness and suffering in either way of being.  But as a society, we must give people the opportunity to find their way the best they can.

Amidst the gloom of NHS pressures and deepening social anxiety, Harewood met a group of young people with psychosis in Birmingham who, through their local NHS Early Intervention Service, can meet up, share experiences, form friendships, get degrees, pursue passions, find girlfriends and boyfriends – all with support on hand when things get rough.  These services are established up and down the country, and hopefully they are making a difference.

And some of the greatest projects are set up by local communities, the voluntary sector and by people with psychosis themselves.  The Psychosis Therapy Project is a specialist psychotherapy service for people who experience psychosis in London, and does wonderful work in giving people the time and space to explore their inner and outer worlds. 

I work as a therapist there, so perhaps I am biased, but the work they/we do is dear to my heart.  Enabling a person who is disappearing completely to re-appear, to find something of themselves, seems to me a sign that, in some ways at least, society is moving in the right direction.